Eradication has been successful but vigilance is needed

Sister Gloria Ekka and her colleagues at a small town hospital in central India are constantly on the alert for possible polio cases.

They have yet to join celebrations as the nation congratulates itself for having gone two years without the degenerative disease.

Almost a year after India was removed from the World Health Organization’s list of polio-endemic nations these volunteers know their job is far from over.

India, which accounted for half the polio cases worldwide three years ago, has not reported a single case since January 13, 2011.

The government has spent around US$ 2.5 billion in its “Pulse Polio” campaign trying to eradicate the disease since 1994, with organizations such as Rotary International and the Bill & Melinda Gates Foundation pitching in.

The country has to thank a vast army of volunteers and partner NGOs as well as the introduction of an improved oral vaccine.

With its public healthcare sector in a shambles, the federal government roped in community organizations and NGOs in its fight against the virus.

The hardest battle was convincing people to have their children immunized.

“Vaccination camps were held across the towns and villages. But people didn’t really care,” says Sister Gloria Ekka, a nun working at a small hospital on the outskirts of Ranchi in Jharkhand.

“Either people were not interested or not aware of the vaccination camps. Most of them would miss their date with the Pulse Polio program. We conducted so many outreach programs in surrounding villages to create awareness about polio,” she adds.

These days, people from distant villages travel to her hospital with their children whenever vaccinations are held.

About 2.3 million volunteers participated in the program to immunize every child under the age of five.

Official statistics are mind boggling. More than 170 million children were vaccinated after volunteers camped at remote hospitals, schools, railway stations, religious congregations and any place that pulled in a crowd.

Over two million houses were visited in a single round.

Volunteers say they won the battle for hearts and minds by constant visits to village families, especially new mothers.

“They involved youths from villages in the campaign and that yielded results,” says Father Tomi Thomas, director general of the Catholic Health Association of India, based in Secunderabad in the southern state of Andhra Pradesh.

However, some health workers say polio eradication will remain a dream for a decade at least.

“If you think polio has been eradicated and we can stop vaccinations as we did smallpox, that is not going to happen for 10 years, perhaps never,” says Jacob Puliyel, a pediatrician at St Stephen’s Hospital in New Delhi.

He pointed to 19 polio outbreaks in the last three years in countries previously declared “polio-free”.

Puliyel, who has co-written a polio vaccination critique in the Indian Journal of Medical Ethics, said it was unethical to prompt poor countries to spend scarce resources on an impossible dream.

International agencies acknowledge the threat. The independent monitoring board of the WHO has recommended India test measures for emergency responses to any polio outbreak.

The sentinels of India’s ambitious campaign keep their cool. They know their battle never ends, especially since neighboring countries are yet to emulate India’s success.

India has set up a series of vaccination booths along its northern border.

Sister Gloria is also not letting her guard down.

“We constantly check for any sign of polio in patients who come to our hospitals. We also conduct health checkups in surrounding villages at least twice a month,” she says.